Ajuben 12

• Chorea associated with Huntington's disease
• Tardive dyskinesia in adults

The precise mechanism by which deutetrabenazine exerts its antichorea effects is unknown but is believed to be related to its effect as a reversible depletor of monoamines from nerve terminals. The major circulating metabolites of deutetrabenazine are reversible inhibitors of VMAT2, resulting in decreased uptake of monoamines into synaptic vesicles and depletion of monoamine stores.

Huntington disease (Chorea) - not switching from tetrabenazine: Initial 6 mg once daily; increase by 6 mg/day weekly; max 48 mg/day (doses >12 mg in 2 divided doses).
Tardive Dyskinesia - not switching from tetrabenazine: Initial 6 mg twice daily; increase by 6 mg/day weekly; max 48 mg/day.
Strong CYP2D6 inhibitors: Maximum 36 mg/day (18 mg twice daily).

Common (>8%): Somnolence (11%), diarrhea (9%), dry mouth (9%), fatigue (9%).
Other (1-10%): UTI (7%), insomnia (7%), anxiety (4%), constipation (4%), contusion (4%), dizziness (4%), akathisia/agitation/restlessness (4%), depression in Huntington's (4%), suicidal ideation (2%), parkinsonism.

There are no adequate data on the developmental risk in pregnant women. Animal studies produced no clear adverse effect on embryofetal development.

Huntington disease patients are at increased risk for suicidality; deutetrabenazine may increase this risk. Risk of akathisia, agitation, restlessness. Sedation/somnolence may impair driving or operating machinery. Periodically reevaluate need for treatment by assessing effect on chorea and adverse effects.

Adverse reactions with overdose: acute dystonia, oculogyric crisis, nausea and vomiting, sweating, sedation, hypotension, confusion, diarrhea, hallucinations, rubor, and tremor.

Keep below 30°C temperature, away from light & moisture. Keep out of reach of children.